HomeMy WebLinkAboutApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: toJ!U2o Permit Number:
•
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 /
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential ✓
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: 547-022xt ln! YX1i�kAt Qr
Property Tax ID #: M7— oQd7 — 000 3 Lot No. 2..
Site Plan Name: Block No.
`
Project Name: �� : L% C.-.`wCL&k.; r1!!z'
DETAILED DESCRIPTION OF WORK:
fc4--�eV c.o ill PJIO i l7Gwts
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit- check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters P- windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $;�1(y-O$' Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name 19.1 IGIA HAWICtAS Name: Edward B lean
AddresslLizo - Gr%�(CI c �- company: Integrity Home Builders of the Palm Beaches
City: PSL State: Address: 231 NE 29th Street
Zip Code: 4N411(0 Fax: City: Boca Raton State: FL
Phone No. Zip Code: 33431 Fax:
E -Mail: Phone N0561-715-6168
Fill in fee simple Title Holder on next page (if different eE-Mailintegrityhomebuilders.el@gmaii.com
Sta
from the Owner listed above)te or County License C -3C_ \' u Qi m
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
M
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
STATE OF FLO AY
Address:
COUNTY OFG\.y.iC�
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
Address:
Personally Known --'OR Produced Identification
Address:
Type of Identification
City:
Produced
City:
Zip: Phone:
CHRISTINA A BROWN
Commission p. PAKCOMMISSIOiSWd�r1063030
Zip: Phone:
EXPIRES January 17, 2021
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SIT THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOU O TTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
ev. 217/19
Owner/ L ssee/Contractor as Agent for Owner
Signature of Contractor/License Holder
ZSignaof
FFLORID
STATE OF FLO AY
OF �t'c,\rn �2aeh
COUNTY OFG\.y.iC�
The fo Ding instrument was acknowledged before me
The for Ding instrument was acknowledged before me
1,iU
this: day of Q�tCG / . 20W by
this day of dG bee- - . 20_L& by
'F \ C eC1
l_.t.
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification ✓
Personally Known --'OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of - t ari
ISignature of ary Public- State of Florida
CHRISTINA A BROWN
Commission p. PAKCOMMISSIOiSWd�r1063030
, N CHRISTINA A R WN
Commission (5g�apn
� ISSION R GUQ63030
EXPIRES January 17, 2021
•:+• r EXPIRES January 17, 2021
REVIEWS
SUPERVISOR
PLANS
MANGROVE
FRONT
ZONING
VEGETATION
SEATURTLE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 217/19